Following surgery, some patients experience a broken bone around the implants of a total hip replacement—called a periprosthetic femoral fracture. In a study of such patients published in the Journal of Bone and Mineral Research, investigators found that 8.3% of patients had atypical femoral fractures, which are a rare type of femoral stress fracture. The researchers also found a strong association between use of bisphosphonates and risk of atypical femoral fractures.

Previous studies have linked bisphosphonate use to atypical femoral fractures in patients with osteoporosis. However, these are very rare events, which are overwhelmed by the fracture prevention effect of bisphosphonates.

“Fractures around orthopedic implants are becoming increasingly more frequent. Our work shines light on the necessity for clinicians to better identify this subgroup of patients with atypical fractures around a femoral implant as they may benefit from different therapies,” said senior author Dr. Etienne Belzile, of CHU de Québec–Université Laval, in Canada.